结核病患者的死因：基于 1931-47 年挪威西部流行病学和尸检记录的研究

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health Pub Date : 2024-10-09 DOI:10.1016/j.jiph.2024.102563

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引用次数: 0

摘要

背景近 50%的肺结核（TB）患者在得不到治疗的情况下死亡。世界卫生组织对结核病死亡的定义并未考虑死亡原因是结核病还是其他非结核病并发症。我们的目的是增进对肺结核患者死因的了解。方法挪威卑尔根豪克兰大学医院盖德病理研究所开展了一项单中心回顾性研究。269名肺结核患者的尸检数据来自尸检期刊，流行病学数据来自1931-1947年间的挪威官方统计手册。结果在流行病学报告中报告的所有肺结核死亡病例中，肺结核占81%，肺外结核占19%。然而，在尸检记录中，只有 21% 的活动性肺结核患者死于肺结核。肺外结核与较高的死亡率明显相关（与肺结核相比，肺外结核的死亡率为 3.27，CI 为 1.91 - 5.61），占结核病死亡病例的 79%。在尸检记录中发现肺外结核病的比例很高（63%），而在流行病学记录中，仅有 4% 的病例报告了肺外结核病。肺外结核病对结核病死亡率的影响似乎被低估了，因为在流行病学数据中，肺外结核病在很大程度上仍未得到充分诊断和报告。

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Cause of death in patients with tuberculosis: A study based on epidemiological and autopsy records of Western Norway 1931-47

Background

Without treatment, nearly 50 % of tuberculosis (TB) patients die. World Health Organization’s definition of TB deaths does not take into consideration whether the cause of death was TB or other non-TB co-morbid conditions. We aimed to improve our knowledge of the causes of death in patients with TB.

Methods

Single-center retrospective study conducted at Gade Institute of Pathology, Haukeland University Hospital, Bergen, Norway. Autopsy data of 269 patients with TB was collected from autopsy journals, and epidemiological data was collected from Norwegian Official Statistics books for period 1931–1947.

Results

Of all TB deaths reported in epidemiological reports, pulmonary TB accounted for 81 % and extrapulmonary TB for 19 %. However, in autopsy records, only 21 % of cases with active pulmonary TB died because of TB. Extrapulmonary involvement was significantly associated with higher mortality (OR EPTB as compared to PTB; 3.27, CI 1.91 – 5.61) and constituted 79 % of deaths attributable to TB. A significant burden of extrapulmonary TB was found in autopsy records (63 %), while in epidemiological records, only 4 % of cases were reported.

Conclusions

Extrapulmonary involvement was a predictor of mortality due to TB in hospitalized TB patients. The contribution of extrapulmonary TB to TB mortality seems to be underestimated because extrapulmonary TB largely remains underdiagnosed and underreported in epidemiological data.

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来源期刊

Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

13.10

自引率

1.50%

发文量

203

审稿时长

96 days

期刊介绍： The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.